Provider Demographics
NPI:1477985984
Name:TAALU, COSKU (LCSW)
Entity Type:Individual
Prefix:
First Name:COSKU
Middle Name:
Last Name:TAALU
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 BOESEL AVE
Mailing Address - Street 2:
Mailing Address - City:MANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08835-2416
Mailing Address - Country:US
Mailing Address - Phone:239-398-4098
Mailing Address - Fax:
Practice Address - Street 1:458 ELIZABETH AVE STE 5-205
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-5110
Practice Address - Country:US
Practice Address - Phone:224-267-5816
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-07
Last Update Date:2021-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC055782001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical